Rabies Vaccine Temperature Excursion Management
Do not use the rabies vaccine if it has been out of the freezer for a few hours—contact the manufacturer or your state/local health department immediately for guidance on whether the vaccine remains potent, and mark the vaccine "do not use" while awaiting their determination. 1
Immediate Actions Required
- Isolate the vaccine immediately by physically separating it and labeling it "do not use" to prevent accidental administration while potency is being assessed 1
- Return the vaccine to proper storage temperatures (refrigerated at 35°F-46°F [2°C-8°C] for most rabies vaccines) while you contact authorities—do not discard until you receive guidance 1
- Document the temperature excursion including exact duration out of proper storage, ambient temperature if known, and any temperature monitoring data available 1
Critical Contact Protocol
- Contact your state or local health department or the vaccine manufacturer immediately to report the temperature excursion and request guidance on whether the vaccine can still be used 1
- Provide specific details: exact time out of storage, storage conditions during the excursion, and whether the vaccine was exposed to freezing or warm temperatures 1
- Do not administer the vaccine to any patient until you receive clearance from health authorities or the manufacturer 1
Why This Matters for Rabies Vaccine
- Rabies vaccines stored in refrigerators (not freezers) are highly sensitive to temperature excursions, and exposure to temperatures outside 35°F-46°F (2°C-8°C) can irreversibly reduce potency 1
- Physical changes are not always apparent after temperature exposure, so you cannot rely on visual inspection to determine if the vaccine is still effective 1
- Freezing temperatures can cause aluminum adjuvant precipitation in many vaccines, resulting in loss of both adjuvant effect and vaccine potency—this damage is permanent 1
Common Pitfall to Avoid
Never assume the vaccine is still good based on appearance alone—vaccines can lose potency from temperature excursions without any visible signs of damage, and administering compromised vaccine could leave patients unprotected against a uniformly fatal disease 1. The stakes are too high with rabies to take any chances.
Temperature Monitoring Best Practices Going Forward
- Implement twice-daily temperature monitoring (at opening and closing) with documented logs kept for at least 3 years 1
- Use calibrated thermometers placed centrally in the storage unit, adjacent to vaccines, certified by appropriate agencies 1
- Consider continuous temperature monitoring systems with after-hours alerts, especially if you maintain large vaccine inventories 1
- Establish written emergency procedures for equipment failures or power outages to prevent future incidents 1